BREASTFEEDING MEDICINE

Volume 8, Number 3, 2013

ª Mary Ann Liebert, Inc.
DOI: 10.1089/bfm.2012.0143

Rusty-Pipe Syndrome: A Rare Cause of Change

in the Color of Breastmilk

Mehmet Nevzat Cizmeci, Mehmet Kenan Kanburoglu,

Ahmet Zulfikar Akelma, and Mustafa Mansur Tatli

Dear Editor: Changes in the color of breastmilk can be of concern for

nursing mothers. When malignant causes are appropri-
W ith adequate support toward preventing the prob-
lems associated with breastfeeding, a new mother’s
chance of successfully breastfeeding her newborn baby is
ately ruled out, brown-colored breastmilk usually results
from an obvious or subtle hemorrhage of the areola or
nipples, both of which cause pain during suckling.3
significantly improved.1,2 We would like to share an unusual
However, there is another distinctly uncommon condition
cause of change in the color of breastmilk to bring it to the
termed "rusty-pipe syndrome." The condition is painless
attention of the journal’s readers.
and remains unnoticed unless the mother is expressing
A female infant was born via cesarean section to a 28-year-
the milk. It is commonly bilateral, and most cases begin at
old gravida 1, para 1 mother at 40 weeks of gestation. The
birth or in early lactation. It is thought to be due to the
infant was admitted to the neonatal intensive care unit be-
delicate network of capillaries, which get traumatized
casue of rapid breathing and had the final diagnosis of
easily and result in blood leaking into breast secretions.
transient tachypnea of the newborn. Expressed breastmilk
To continue breastfeeding is recommended as the condi-
was brought by the mother on Day 2 that was dark brown in
tion is self-limited, and most cases clear within the first
color, coming out of both breasts (Fig. 1a). The mother de-
week.4
nied any history of pain, trauma, or recent infection. Ex-
During our search for the name of this condition, we have
amination of the breasts revealed no engorgement,
encountered only one report 4 in the MedLine literature
tenderness, or erythema. The nipples and areola had no
database to describe this benign and self-limited condition.
erosions, ulcers, or cracks. The mother was reassured, so that
We thought it would be appropriate to bring it to the
breastfeeding continued, and the breastmilk decolorized
attention of staff engaged in breastfeeding of newborn
within 72 hours (Fig. 1b and c).
infants.

FIG. 1. (a) Rusty-colored breastmilk drawn into a syringe for demonstration on Day 1. (b) Decolorization begins within 24
hours. (c) The normal color of a 1-week-old breastmilk sample is shown for comparison.

Division of Neonatology, Department of Pediatrics, Fatih University Medical School, Ankara, Turkey.

340
LETTER TO THE EDITOR 341

References Address correspondence to:

Mehmet Nevzat Cizmeci, MD
1. Clark DL, Rudert C, Mangasaryan N. Breastfeeding: A pri-
Division of Neonatology
ority for UNICEF. Breastfeed Med 2011;6:349–351.
2. Sayyah Melli M, Rashidi MR, Delazar A, et al. Effect of Department of Pediatrics
peppermint water on prevention of nipple cracks in lactating Fatih University Medical School
primiparous women: A randomized controlled trial. Int Alparslan Turkes Cd. No: 57
Breastfeed J 2007;2:7. 06510, Emek/Ankara, Turkey
3. Morland-Schultz K, Hill PD. Prevention of and therapies for
nipple pain: A systematic review. J Obstet Gynecol Neonatal E-mail: nevzatcizmeci@gmail.com
Nurs 2005;34:428–437.
4. Virdi VS, Goraya JS, Khadwal A. Rusty-pipe syndrome. In-
dian Pediatr 2001;38:931–932.